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Complications

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The complications of subclinical hyperthyroidism include:

  • increased all cause mortality:
    • in patients aged over 60 and with a single low TSH level, the standardised mortality ratio was between 1.7 and 2.1 over the following five years
    • most of this effect was caused by increased death from cardiovascular disease

  • increased risk of atrial fibrillation:
    • patients aged 60 or older who have a TSH <0.1 mU/L have a relative risk of atrial fibrillation at 10 yr follow-up of 3.1

  • increased risk of Alzheimer's disease and dementia:
    • patients with a TSH <0.4 mU/L have a relative risk of dementia of 3.5

  • increased risk of vertebral fractures:
    • the rate of vertebral fractures is 4.4 fold higher in patients with a TSH <0.1 mM/L compared to controls

Reference:

  • 1) Parle, JV, Maisonneuve, P, et al. Prediction of all-cause and cardiovascular mortality in elderly people from one low serum thyrotropin result: a 10-year cohort study. Lancet, 358, 861-65.
  • 2) Sawin, CT, Geller, A, Wolf, PA, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med 1994, 331, 1249-52.
  • 3) Kalmijn, S, Hehta, KM, Pols, HAP, et al. Subclinical hyperthyroidism and the risk of dementia. The Rotterdam Study. Clin Endocrinol (Oxf). 2000, 53, 733-37.
  • 4) Bauer, DC, Ettinger, et al. for the Study of Osteoporotic Fractures Research Group. Risk for fracture in women with low serum levels of thyroid-stimulating hormone. Ann Intern Med, 2001, 134, 561-68.

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